© Allan Karlsson Västra Götaland, Sweden Västra Götaland – winter General overview Västra Götaland is one of the three most regional bodies are responsible for financing and populated regions in Sweden. Situated on delivering health services to citizens; and at the the west coast, it encompasses forests and local level, 290 municipalities are responsible for agricultural land, a coastline and an archipelago care of the elderly and people with disabilities (3). with small villages, 49 middle-sized municipalities Region Västra Götaland (VGR) (4), one of and one large city, Gothenburg (population Sweden’s largest organizations with 55 000 564 034 in 2017) (1). employees and an annual turnover of SEK 60 Västra Götaland, home to the largest port in the billion, is responsible for public organization in country, is one of the leading regions in Sweden as the Region. Its governing bodies are the Regional far as industry and transportation are concerned. Council (comprising 149 political members) and The population of the geographical area of the Regional Executive Board (comprising 15 Västra Götaland is 1.6 million. Life expectancy political members). Elections to these councils are is 83.9 years for women and 80.3 years for men, held every four years. equivalent to the national figures. The proportion of VGR’s main responsibility relates to the health- foreign-born people is 21%, slightly lower that the care sector, which includes 17 hospitals, 200 average for Sweden (22%) (2). primary-care centres and 170 dental clinics. The Swedish health-care system is mainly Research, innovation and education are also government-funded and decentralized, financed major responsibilities of VGR. The region is primarily through taxes levied by county councils home to the renowned Sahlgrenska University and municipalities. All three levels of Swedish Hospital and several science centres. VGR has a government are involved in the health-care national mandate to take the lead in the regional system: at the national level, the Ministry of development of several areas, such as business, Health and Social Affairs is responsible for overall culture, environment, public transport, public health and health-care policy, working in concert health promotion and human rights. with eight national government agencies; at The political vision of VGR is currently “to the regional level, 12 county councils and nine provide a good life”. In 2003, the Swedish Parliament decided on a public health policy Reducing school failures – an overall priority with the overarching goal, “to create the societal The Regional development strategy of Region conditions for good health on equal terms for Västra Götaland 2014–2020 (VG2020) (6) the entire population”. The policy had a clear stipulates that skills and competencies in the focus on public health promotion and all sectors population are crucial for the future development of society were required to recognize their and growth of people, companies and responsibilities in reaching the goal. The policy institutions. The link between education and was reviewed in 2008 and minor changes made. health is strong, representing a visible social In 2017, the Swedish Commission for Equity in gradient. One of VGR’s overall priorities is, Health published the report entitled, The next step therefore, to reduce school failures and increase towards more equity in health in Sweden – how the number of school leavers eligible to study can we close a gap in a generation? (5), which at a higher level. It is obvious that finding the could lead to further amendments of the policy, right solution is the responsibility not only of the including a stronger focus on health equity. municipal school system but also of VGR, both Several VGR committees are formally responsible as a leading partner in regional development and for public health, namely, the five health and as a health authority and health-service provider. medical care committees and the Public Health To achieve long-lasting, sustainable commitment, Committee. Together with the municipalities, the VGR needs to acknowledge the importance health and medical care committees coordinate of cross-sector cooperation both within the and agree on frameworks for local public health organization and with relevant statutory and non- work, which is financed by both VGR and the statutory stakeholders. It is important that action municipalities on an equal basis. The Public taken in this area be both generic and specific. Health Committee acts as a strategic engine Cross-sectoral action has been identified in five in relation to public health promotion in the areas, namely: region, creating policy frameworks, initiating 1. promotion of sustainable cross-sector new methods of working and monitoring the cooperation; development of population health. 2. promotion of mental health and fight against Public health promotion focuses on creating the consequences of mental illness; equal access to preconditions for good health throughout the life-course. 3. stimulation of the joy of studying; 4. reduction of the negative impact of migration on school achievement; 5. reduction of the impact of social determinants and risk factors for disease. Strengths Västra Götaland’s strengths include: strong development potential (the business sector is a high standard of health and steadily increasing life 9 9 highly influenced by research and development); expectancy; fast-growing tourism, cultural and creative industries; health indicators with positive trends (fewer people 9 9 smoking, fewer people drinking alcohol and no increase in obesity). Västra Götaland, Sweden Aspirations VGR is aiming to: fight exclusion and segregation, and strengthen the strengthen primary-care services in addressing 9 9 link between education and working life; mental health. strengthen the possibilities for children and teenagers 9 to take part in cultural activities; Challenges These are: the persistent problem of matching the demand for a the need for continued strong and forceful innovation 9 9 skilled, experienced and highly educated workforce to maintain sustainable development in the region; while many seeking work today have low levels of increasing inequity throughout the region, particularly 9 education and no experience of being in the Swedish that resulting in failure to graduate from school to labour market; institutions of further education. Potential areas of collaboration VGR is interested in collaborating with other RHN regions in the following areas: health and education (with a view to implementing health equity (in particular, the importance of 9 9 the region’s strategy and action plan, “Joint action for addressing gaps in knowledge, trust and language reducing school failures”); that affect people’s access to health-care services the Sustainable Development Goals (SDG’s) (7) and and treatment). 9 regional development (particularly in connection with the process of establishing a new regional development strategy for Västra Götaland); Working groups VGR is interested in participating in working groups on: the Sustainable Development Goals (SDGs) (7)/ 9 equity; 9 the all-of-government approach/intersectoral action; 9 education and health. Västra Götaland, Sweden People active in the Regions for Health Network (RHN) Political focal point Others Gunnel Adler Elisabeth Rahmberg Chair, Public Health Committee Director of Public Health Region Västra Götaland Region Västra Götaland Mariestad Mariestad Email: [email protected] Email: [email protected] Technical focal point Håkan Linnarsson Elisabeth Bengtsson Regional Commissioner Senior Public Health Adviser Public Health Committee Region Västra Götaland Region Västra Götaland Mariestad Mariestad Email: [email protected] Email: [email protected] References 1. Statistik och analys [Statistics and analyses). In: Göteborgs Stad [Gothenburg City] [website]. Gotherburg: 2018 (http://statistik.goteborg.se/, accessed 16 April 2018). 2. Populär statistic [Popular statistics]. In: SCB [website]. Stockholm: Statistiska centralbyrån; 2018 (www.scb.se, accessed 15 April 2018). 3. Gelnngård AH. The Swedish health care system. In: International Health Care System Profiles [website]. New ork,Y NY: The Commonwealth Fund; 2018 (http://international.commonwealthfund.org/countries/sweden/, accessed 15 April 2018). 4. Västra Götalandsregionen [Västra Götalands region] [website]. Vänersborg: Västra Götalandsregionen; 2018 (www. vgregion.se, accessed 15 April 2018). 5. Lundberg O. The next step towards more equity in health in Sweden – how can we close a gap in a generation? Stockholm: Kommissionen för Jämlik Hälsa [Commission for Equal Health]; 2017 (http://kommissionjamlikhalsa.se/ publikationer/next-step-towards-equity-health-sweden, accessed 15 April 2018). 6. Regional development strategy of Region Västra Götaland 2014–2020 (VG2020). In: Growth – internal market, industry, entrepreneurship, and SMEs [website]. Brussels: European Commission; 2018 (https://ec.europa.eu/growth/ tools-databases/regional-innovation-monitor/policy-document/strategy-growth-and-development-v%C3%A4stra- g%C3%B6taland-vg2020, accessed 15 April 2018). 7. Sustainable Development Goals. In: Sustainable Development Knowledge Platform [website]. New York: United Nations; 2018 (https://sustainabledevelopment.un.org/sdgs, accessed 15 April 2018). Västra Götaland, Sweden © World Health Organization 2018.